The best allergy medicines for kids include a nasal spray or medications taken by mouth, but they are not safe for all age groups.

Published: August 25, 2022 | Updated: October 18, 2024

If your child has seasonal allergies, you may be wondering what is the best over-the-counter allergy medicine for kids. According to allergists, the medication that can offer the best relief likely depends on a child’s age and symptoms. Generally speaking, nasal steroid sprays tend to be the best daily medication to treat allergies and have the widest therapeutic benefit.

Which allergy medicine is best for kids?

“Oral medications cetirizine, loratadine and fexofenadine are three common over-the-counter antihistamines commonly used to treat allergies. Although one is typically not preferred over the other, the side effects and how quickly the medication takes effect can vary,” said Chandra V. Vethody, M.D., pediatric allergist and immunologist with Norton Children’s Allergy & Immunology, affiliated with the UofL School of Medicine.

Cetirizine (Zyrtec) tends to be the most fast-acting medication — that can take effect in as little as one hour — but it also carries the highest potential for drowsiness. Loratadine (Claritin) can take up to three hours to take effect and may cause minor drowsiness. Fexofenadine (Allegra) can take effect within two hours and also is completely nonsedating. All three medications last for around 24 hours. 

Although diphenhydramine (Benadryl) is a well-known antihistamine, it is no longer recommended as a first-line treatment for allergies due to having more severe side effects, including sedation and overdose.

Nasal sprays or oral antihistamines?

The best allergy medicines for kids include a nasal spray or medication taken by mouth:

Nasal steroid spray: Helps with runny nose, congestion/stuffy nose, sneezing and itching

• Example: Children’s Flonase (ages 4 and up)

Oral antihistamine: Helps with runny nose, sneezing and itching (does not ease congestion/stuffy nose)

• Example: Zyrtec, Claritin, Allegra (ages 2 and up)

“Always check with your child’s pediatrician before using a nasal spray or any other form of antihistamine or cold medication for your child,” Dr. Vethody said. “Not all formulations and dosages are safe for all ages.”

According to the Food and Drug Administration, children under age 2 are not to be given any type of decongestant or antihistamine due to potentially serious and life-threatening side effects, including convulsions, rapid heart rate and death.

If over-the-counter medications don’t help, your child’s pediatrician may recommend seeing an allergist with Norton Children’s Allergy & Immunology.